Dealing with vaginal dryness

One of the more annoying situations that many of my patients have been in is having painful intercourse due to vaginal dryness. In general the cause of dryness of the vaginal tissue is lack of estrogen. This can occur postpartum, especially in women who are breastfeeding a baby, and it can occur just before and during menopause.

When estrogen is in the body, one of the effects of estrogen is to cause the vaginal tissue to be moist, flexible and plump. When the estrogen level is low, the vaginal tissue becomes thin, dry and tight. There is less moisture expressed with foreplay and arousal, and there can be pain and even tissue tearing and bleeding with vaginal penetration.

For many women, what is needed is a good vaginal lubricant to be used during intercourse. There are three main types of lubricants – water based, silicone based and hybrids. Water based, such as regular KY Jelly, Astroglide or Slippery Stuff, tend to disappear quickly, and are useful when some extra lubrication is needed. Silicone based lubricants last longer, and hybrids are a combination of water and silicone based. Pjur Eros is silicone based lubricant. Other options for lubricants include using coconut oil or Crisco.

A woman may need to try several of these to find one that works well for her. For some women, lubricants alone are not enough. Giving a woman estrogen in a vaginal form can help that dry thin tissue become thick, moist and flexible. It often takes one to two months of regular use to reverse the changes of lack of estrogen. The estrogen dose taken to help vaginal dryness is quite low, much lower than taking estrogen for hot flashes. Estrogen comes in a vaginal cream, a vaginal pill and in a vaginal ring (the latter is left in for 3 months). All require a prescription, so speak to your doctor about which option is best for you. There is no need to suffer with vaginal dryness!